I received the following as a series of 13 text messages from Anil sent at 10:21pm ET/Haiti time. I’ve made minor spelling and grammar corrections and have tried my best to fill in missing words using brackets and add some light styling for readability. I’ve also added a few links to the medical terms. Warning: this is hard to read

From Anil Menon:

“How was your day?”

I’ve had to answer that question throughout the day, and at first I said good, with a rote response, but then I just had to tell the truth because it wasn’t good, it was horrible.

After 48 hours of traveling, very little sleep, not much food, I had no desire for food or sleep, because the rubble of port au prince was strewn with injured people, in even worse condition on day 5.

Everyone felt that way, and no one expected to sleep, for sure not peacefully. On this first day I sent home a woman who lost her right leg, sent her home with several vicodin because her leg did not show signs of infection yet and hoped that keflex would be sufficient. A translator, manny, wanted to help because his entire family was dead and he had nothing else, and he was helpful.

Baratunde asked about the saddest case, and that was the kids, one girl with an open pelvic fracture was urinating blood, somehow, like many others, she didn’t cry even though the pain must have been excruciating and the wait for an [operating room] an overnight event, and now I’m hoping she is still with us tomorrow.

At this point most of the fractures and lacerations are days old, the maggots and bacteria have set in, and the bone looks dark as it protrudes through the skin. Our hope is that by losing a limb we can prevent losing a life, and our ER is backing up with post operative amputations.

Of course this makes it harder to see new patients and we often discharge them on their first post operative day. An ER physician might do a fasciotomy or stienmann pin as every pushes beyond. Due to resource and logistic issues (which are really maximized by [International Medical Corp?] but constrained by the territory) the saying goes that you would treat every single patient [as if they were?] in the U.S but you can only treat a few patients here. That is what makes the situation unbearable, being trained to help someone, but having so many people tug at your arm, need an immediate response but only being able to answer a few.

Anil Menon, MD is a clinical instructor at Stanford School of Medicine focused on surgery and emergency medicine. His research interests are Aerospace Medicine, Emergency Medicine, and Wilderness Medicine. He graduated from Stanford Med in 2006, received a degree in mechanical engineering in 2003 and became a full ER doctor in 2009. He has practiced medicin in combat in Afghanistan and will be practicing aerospace medicine next year at NASA. He’s part of a team sent to Haiti by Stanford.

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